PLoS ONE (Jan 2021)

Lack of effect on in-hospital mortality of drugs used during COVID-19 pandemic: Findings of the retrospective multicenter COVOCA study.

  • Pia Clara Pafundi,
  • Raffaele Galiero,
  • Vittorio Simeon,
  • Luca Rinaldi,
  • Alessandro Perrella,
  • Erica Vetrano,
  • Alfredo Caturano,
  • Maria Alfano,
  • Domenico Beccia,
  • Riccardo Nevola,
  • Raffaele Marfella,
  • Celestino Sardu,
  • Carmine Coppola,
  • Ferdinando Scarano,
  • Paolo Maggi,
  • Pellegrino De Lucia Sposito,
  • Laura Vocciante,
  • Carolina Rescigno,
  • Costanza Sbreglia,
  • Fiorentino Fraganza,
  • Roberto Parrella,
  • Annamaria Romano,
  • Giosuele Calabria,
  • Benedetto Polverino,
  • Antonio Pagano,
  • Carolina Bologna,
  • Maria Amitrano,
  • Vincenzo Esposito,
  • Nicola Coppola,
  • Nicola Maturo,
  • Luigi Elio Adinolfi,
  • Paolo Chiodini,
  • Ferdinando Carlo Sasso,
  • COVOCA Study Group

DOI
https://doi.org/10.1371/journal.pone.0256903
Journal volume & issue
Vol. 16, no. 9
p. e0256903

Abstract

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IntroductionDuring COVID-19 pandemic, the use of several drugs has represented the worldwide clinical practice. However, though the current increase of knowledge about the disease, there is still no effective treatment for the usage of drugs. Thus, we retrospectively assessed use and effects of therapeutic regimens in hospitalized patients on in-hospital mortality.MethodsCOVOCA is a retrospective observational cohort study on 18 COVID centres throughout Campania Region Hospitals. We included adult patients with confirmed SARS-CoV-2 infection, discharged/dead between March/June 2020.Results618 patients were included, with an overall in-hospital cumulative mortality incidence of 23.1%. Most prescribed early treatments were antivirals (72%), antibiotics (65%) and hydroxychloroquine/anticoagulants (≈50%). Tocilizumab, indeed, was largely prescribed late during hospitalization. Multivariable models, with a cut-off at day 2 for early COVID-19 therapy administration, did not disclose any significant association of a single drug administration on the clinical outcome.DiscussionCOVOCA represents the first multicenter database in Campania region. None drug class used during the pandemic significantly modified the outcome, regardless of therapy beginning, both overall and net of those already in non-invasive ventilation (NIV)/ orotracheal intubation (OTI) at hospitalization. Our cumulative incidence of mortality seems lower than other described during the same period, particularly in Northern Italy.